English Football Must Install Better Standards for the Issue of Concussions

By | November 3, 2013

In case you missed it this morning, there was a very frightening moment during the Everton-Tottenham match. While attempting to get on the end of a long ball, Romelu Lukaku and Hugo Lloris had a terrible collision, where Lukaku’s knee ran directly into Hugo Lloris’s face, ending in both players being injured. However, Lloris’s was obviously the one with the more severe injury, as he laid face down on the grass for several minutes. The medical staff was called onto the pitch and stayed with him to check on his condition and help him regain composure. As one would expect following this frightening injury, Tottenham’s second-string keeper, Brad Friedel, started to warm-up to enter the game for his teammate. However, as Lloris was being ushered off of the field he started to fight back suggesting that he wished to stay in the game. While his dedication to his team was admirable, there was no way he should remain on the field following that sort of injury, especially with such a high severity risk of second-impact syndrome, which can significantly worsen any concussion. [1] But to the surprise of many, the commentators included, he remained on the field, and finished the game.

In the post game interview Tottenham manager, Andre Villas-Boas, was asked about this decision. He responded that he felt it was the right decision despite the fact that medical officials suggested a substitution, and that Lloris had mentioned that he could not remember what happened. [2] This information provided a clear indication that he should have been removed from the game to ensure future safety. However, this negligence is nothing new for the premier league, as Romelu Lukaku himself had a similar concussion scenario earlier this year. In a game against West Ham, Lukaku was knocked unconscious while scoring the game-winning goal and stated,  “I didn’t even know that I scored. …I didn’t remember what happened for a couple of seconds.” [3] Furthermore, he even played 3 days later in a cup match, showing a complete disregard for any sort of concussion monitoring, which is a serious issue.

In order to assess the English leagues’ true knowledge about concussions, a questionnaire was sent out at the beginning of the 2009/2010 season. [4] The results were quite surprising where only about three quarters of the teams in England that responded were aware of the Consensus in Sport guidelines pertaining to concussions. Furthermore, only a little over half of the teams used cognitive assessments following a concussion, and only a very small amount followed the review of symptoms and proper rest periods, thus demonstrating a significant mistreatment of the condition. If the English leagues truly want to ensure the safety of their players, they should take after the MLS concussion policies. [5] The MLS policy is a three-step system, where the player must pass cognitive tests, be symptom-free and have clearance from both the team doctor, and team appointed neuropsychologist, a new requirement for every team. If the English leagues truly want to ensure the greatest quality of football as well as the health of their players, they must take the steps necessary to better address this issue of concussions.



[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672291/

[2] http://www.dailymail.co.uk/sport/football/article-2486571/Andre-Villas-Boas-admits-Lloris-remember-hit-Tottenham-manager-let-goalkeeper-carry-regardless.html

[3] http://prosoccertalk.nbcsports.com/2013/09/26/romelu-lukaku-situation-shows-need-for-premier-league-concussion-policy/

[4] http://group.bmj.com/group/media/latest-news/most-english-football-teams-don2019t-follow-international-guidelines-on-concussion

[5] http://espn.go.com/sports/soccer/news/_/id/7436065/mls-medical-staffers-target-concussion-protocol

2 thoughts on “English Football Must Install Better Standards for the Issue of Concussions

  1. Jordan Cirocco

    Halsey, after reading your post and looking at a replay of the incident, I was really curious about the rules regarding concussions and player’s safety in the premier league. According to a recent article in the NY Times, the Premier League concussion policy only covers a situation where a player is substituted from a game due to a head injury, in which the player subsequently can not play for five days. The article exposes the loophole of the policy, stating that “Because Lloris did not leave the game, he technically did not sustain a head injury, despite all evidence to the contrary.” With no firm policy in place, and no neutral medical officials to determine the extent of a head injury, I feel that situations like these will continue to occur in the near future. Hopefully the backlash from this incident will be enough for Premier League officials to review the league’s concussion policy. And if the public backlash is not incentive enough, they should just look at the $765 million dollar settlement the NFL was forced to hand over to ex-players suffering from the league’s lack of concern for player safety.

  2. Ramsey Al-Khalil

    I was also watching this match and was appalled when they let Lloris remain in the game. The severity of head injuries warrants immediate medical attention, let alone a substitution from a soccer game. This incident also sparked an interesting discussion with my Mammalian Toxicology professor today. He mentioned to me that he’d been traveling in Europe to give a talk about his current research regarding biomarkers for nervous system damage. A major issue with determining the long-term effects of head injuries has been the long delay in diagnosis. However, his lab has determined that certain molecules called biomarkers can be quantified in order to determine someone’s risk for subsequent head injuries. These findings are obviously very applicable to sports medicine, but they also complicate the business of running sports organization. Unless they’re required to do so, managers may not want to know whether their players, especially stars, are medically-cleared to play. If a big name or tactically-important player cannot play, teams suffer in terms of ticket revenue, fan satisfaction, and quality of play. Despite this loss, player safety and health must remain everyone’s first priority. Hopefully legislation catches up in the near future before anyone else is seriously injured and continues to play through it.


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